Utilization Review Nurse RN Job at LifeBridge Health, Inc., Baltimore, MD

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  • LifeBridge Health, Inc.
  • Baltimore, MD

Job Description

LifeBridge Health, Inc. seeks a Utilization Review Nurse RN to evaluate medical necessity, level of care, and length of stay for hospitalized and ambulatory patients. The nurse reviews clinical documentation using InterQual/MCG and payer guidelines, collaborates with physicians and care teams, and communicates with insurers to obtain authorizations and prevent denials. Responsibilities include concurrent and retrospective review, documentation clarification, and escalation of complex cases. The role supports safe, cost-effective care, regulatory compliance, and optimal patient outcomes in a mission-driven, community-focused health system with strong opportunities for growth.

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